obesity therapeutics

obesity is associated with increased risk of death due to

CV disease and cancer

risk factors for obesity include

poor health behaviors, stress, health conditions, genetic disorders, medications, systems and environment

healthy BMI

18.5-24.99

overweight BMI

>25

obese BMI

>30

severe obesity BMI

>40

waist circumference >__ for males and __ for females is associated with increased risk of comorbidities of obesity

94 cm, 85 cm

patients who carry weight around midsection may be at higher risk of __

heart disease, t2DM, premature death

non-pharm obesity therapy

diet, exercise, behavior modification

when is bariatric surgery recommended

BMI > 35 with comorbidity, or BMI > 40

__ is required to achieve weight loss

energy deficit of 500-750 kcal/day

how much aerobic activity is recommended for weight loss

200-300 min/week

behavior modifications for weight loss

self monitoring of food intake, physical activity, weight, interventions

when should medications be used in weight loss

BMI > 27 with 1 or more comorbidity, BMI >30 with no comorbidity

considerations for all anti-obesity medications

avoid in pregnant women, consider insulin, HTN, eating disorders

AGA suggests againt use of __

orlistat

__ have conditional and low weight loss results

phentermine and diethylpropion

Saxenda and Wegovy are approved for patients over__

12 years old

Zepbound is a __

GLP/GIP RA

ways to manage side effects of GLP1

improve eating habits, lifestyle changes, adapt what foods you are eating

Contrave (naltrexone-bupropion ER) MOA

effects may result from action on areas of the brain involved in the regulation of food intake

Contrave contraindications

concomitant use of other bupropion-containing products or MAOIs, opioid use, uncontrolled HTN, seizures, bulimia or anorexia

Contrave may benefit patients who are __

attempting smoking cessation, depression

Qsymia (phentermine-topiramate) MOA

phentermine stimulates release of NE to reduce appetite, topiramate effects appetite suppression and satiety

Qsymia contraindications

hyperthyroidism, glaucoma, MAO-I, pregnancy

__ should be monitored with Qsymia

pregnancy and effective contraception use

Qsymia should be avoided in

history or strong risk of CV disease

Qsymia side effects

increased heart rate, constipation, dry mouth, headache, insomnia

phentermine alone is only approved for __

short term use (12 weeks)

contra for phentermine

history of CV disease, hyperthyroidism, glaucoma, agitated states, drug abuse, MAOI, pregnancy/breastfeeding

phentermine side effects

increased BP and HR, anxiety, dizziness, headache, insomnia

diethylpropion MOA

stimulates release of NE to reduce appetite

Diethylpropion is only approved for __

short term use (12 weeks)

diethylpropion contraindications

CV conditions, hyperthyroidism, glaucoma, agitated states, history of drug abuse, MAO-I

Diethylpropion side effects

increased HR, HTN, anxiety, dizziness, drowsiness, GI issues

laws require __ when prescribing controlled weight loss drugs

prior treatment, physical exam, documentationa

according to ohio law, evaluation of weight loss must be done every __ to continue treatment

3 months

orlistat is avoided in weight lose due to __

GI side effects

orlistat should be taken__

2 hours apart from other medications with fatty meal

__ when discontinuing phentermine/topiramate

gradual taper